| National Provider Identifier [NPI]: | 1194700047 |
| Last Name Of The Provider | MENDEZ |
| First Name Of The Provider | DANAE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 HIGHLAND AVE |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | LEWISTOWN |
| Zip Code Of The Provider | 170441167 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 6410 |
| Number Of Medicare Beneficiaries | 2780 |
| Total Submitted Charge Amount | 823872 |
| Total Medicare Allowed Amount | 167029.39 |
| Total Medicare Payment Amount | 129608.73 |
| Total Medicare Standardized Payment Amount | 133551.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 6410 |
| Number Of Medicare Beneficiaries With Medical Services | 2780 |
| Total Medical Submitted Charge Amount | 823872 |
| Total Medical Medicare Allowed Amount | 167029.39 |
| Total Medical Medicare Payment Amount | 129608.73 |
| Total Medical Medicare Standardized Payment Amount | 133551.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 721 |
| Number Of Beneficiaries Age 65 to 74 | 963 |
| Number Of Beneficiaries Age 75 to 84 | 697 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 1875 |
| Number Of Male Beneficiaries | 905 |
| Number Of Non Hispanic White Beneficiaries | 2705 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1786 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 994 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4882 |